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Ocular Impression-Based Scleral Lens With Wavefront-Guided Optics for Visual Improvement in Keratoconus
John D Gelles1, Brian Cheung, Sarah Akilov
1Cornea and Laser Eye Institute-Hersh Vision Group (J.D.G., B.C., S.A., S.K., G.T., S.A.G., D.C., P.S.H.), CLEI Center for Keratoconus, Teaneck, NJ; and Department of Ophthalmology (J.D.G., S.A.G., P.S.H.), Rutgers-New Jersey Medical School, Newark, NJ.
Eye & Contact Lens
|August 2, 2022
Summary
This study introduces wavefront-guided scleral lenses for keratoconus, improving vision after traditional lenses failed. The new lenses significantly reduced visual distortions and enhanced visual acuity.
Area of Science:
- Ophthalmology
- Optometry
- Biomedical Engineering
Background:
- Keratoconus (KC) presents challenges for vision correction, often requiring specialized contact lenses.
- Traditional scleral lenses (tSL) may not fully address higher-order aberrations in KC patients.
- Custom ocular impression-based scleral lenses (IBSLs) offer a tailored approach to scleral lens fitting.
Observation:
- A 28-year-old male patient with KC experienced suboptimal vision with a tSL.
- IBSLs with traditional optics were fit, but further visual enhancement was sought.
- A novel system was employed to create wavefront-guided IBSLs (wfgIBSLs) using a dot matrix and wavefront aberrometry.
Findings:
- The wfgIBSL demonstrated a significant reduction in higher-order root mean square (HORMS) aberrations by 67% in the right eye and 64% in the left eye.
- Best-contact lens visual acuity (BCLVA) improved by two lines in both eyes with the wfgIBSL compared to the standard IBSL.
- The wfgIBSL provided a stable lens fit and improved visual outcomes.
Implications:
- Wavefront-guided optics integrated into custom IBSLs represent a promising advancement for managing complex KC visual impairments.
- This technology offers a potential solution for patients who have not achieved satisfactory vision with conventional scleral lens designs.
- Further research into wfgIBSLs could lead to enhanced visual rehabilitation strategies for irregular corneas.
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